U.S. Moves to Develop U.S.-Mexico Border Health Commission 

By Lou Valdez, MS


Closing the Gap, Hispanic Agenda for Action • October 1998


I

n October 1994, the U.S. Congress passed Public Law 103-400, 

which authorizes the President to conclude an agreement with 

Mexico to establish a United States-Mexico Border Health Commission (BHC). In Fiscal Year 1998, Congress appropriated $800,000 

to HHS to fund U.S. participation in the Commission, which will 

target the U.S.-Mexico region that spans California, Arizona, New 

Mexico and Texas. 

The primary goals of the Commission are to institutionalize a 

domestic focus on border health which can transcend political changes, 

and create an effective venue for binational discussion to address public health issues and problems that affect the U.S.-Mexico border 

populations. 

Salient Features of the Law 

Under U.S. law, the BHC is mandated to: 

•	 Conduct a comprehensive needs assessment in the border area for 

the purpose of identifying, evaluating, preventing and resolving 

health problems that affect the general population of the area. 

•	 Implement actions recommended by the needs assessment through 

assisting in the coordination of public and private efforts to prevent and resolve health problems, and educate the population 

concerning such health problems in a culturally competent manner. 

•	 Conduct or sponsor investigations, research, or studies designed to 

identify and monitor health problems that affect the general population in the border area. 

•	 Conduct or support a binational, public-private effort to establish 

a comprehensive and coordinated system, which uses advanced 

technologies to the maximum extent possible, for gathering healthrelated data and monitoring health problems in the border area. 

•	 Provide financial, technical or administrative assistance to public 

or private persons who act to prevent, resolve, or educate such 

population concerning such health problems. 

Major Challenges 

The framers of the legislation believed that the BHC would 

require significant participation and support from Federal and State 

representatives of both countries. The Commission has the challenge 

of bringing together effective Federal, State and local public and private capabilities and resources in dynamic partnerships to improve the 

health and well being of border populations through creative multisectoral approaches. 

Equally important in establishing the BHC is ensuring appropriate and effective Mexican participation, while respecting the various 

legal jurisdictions and legislative authorities between the Federal and 

State levels of the U.S. and Mexico. HHS maintains an informal 

dialogue with Secretariat of Health of Mexico on the creation of the 

BHC and Mexico’s important role. In January 1998, 

HHS requested the Department of State to explore— 

with appropriate Mexican government officials—the potential for participation in the BHC. If and when Mexico decides to 

participate, it may vary widely from the U.S. effort. 

The challenge is to develop a commission that is sustainable and 

meaningful for U.S. and Mexican stakeholders. The BHC must create awareness and political will across a wide constituency about the 

U.S.-Mexico border, its populations, and environment. It must have 

sufficient breadth and depth to assure that attention to the border 

will transcend political change. Through outreach efforts, data collection and analysis, and joint collaborative action based on an agenda 

developed through a consensus process, the BHC can educate others 

about the unique challenges at the border. And, the BHC can create 

a shared commitment among the public and private sector to find 

solutions that involve collective and coordinated actions by government, non-governmental organizations, and the communities involved. 

The BHC should become a forum for tackling critical issues, and 

developing the necessary resources, e.g., political will, community 

commitment, technical expertise, and financial resources, to address 

border needs. To achieve its goals, the BHC must incorporate several 

key elements into its development/management process. It must have 

the formal commitment of both political parties in the U.S. Border 

States, the State governors currently in office, the State commissioners/directors of Health and mayors of border cities. Essential elements 

for BHC success include effective communication channels, capacity 

for advocacy, commitment to binational solutions, and sustainable 

infrastructure. 

The BHC must respect and acknowledge the differences in systems, policies, politics, and cultures between the two countries and 

across the border States. It is these very differences, as well as the 

similarities of problems and concerns, that make the U.S.-Mexico 

border and the Border Health Commission unique. 

Composition Offices 

The Secretary of HHS or her designee will serve as chair for the 

U.S. side of the Commission. The commissioners of health or chief 

health officers for Texas, New Mexico, Arizona, and California will 

also serve as Commission members. Two individuals who have demonstrated ties to community-based organizations from each of the 

states of Texas, New Mexico, Arizona, and California, nominated by 

the chief executive officer of the respective states and appointed by 

the President, will complete the U.S. membership. 

Staff responsibility for establishment of and support for the BHC 

has been placed in the Office of International and Refugee Health, 

Office of Public Health and Science, Office of the Secretary. 

The appointment process for the U.S. Commissioners who represent border constituents is underway. A design team of federal and 

state partners has been selected to help prepare Commissioners, once 

they are selected and appointed by the President, for the first Border 

Health Commission meeting. 

Lou Valdez, is International Officer for the Americas, 

Office of International and Refugee Health, HHS.

Office of Minority Health Resource Center	 U.S. Department of Health and Human Services